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目的:观察机械通气联合不同剂量西地那非治疗新生儿持续性肺动脉高压（PPHN）的疗效及安全性。方法:选取2018年1月至2019年12月德州市妇幼保健院收治的PPHN患儿160例，根据随机分层法分为A、B、C、D四组，各40例。入组患儿均积极纠正酸中毒，给予静脉营养支持、保暖、抗感染等措施，并采用呼吸机辅助机械通气，A、B、C组分别给予0.5 mg/（kg·次）、1.0 mg/（kg·次）、2.0 mg/（kg·次）西地那非治疗，D组不给予西地那非治疗，仅采用机械通气。检测四组患儿治疗前和治疗72 h后血气分析指标[动脉血氧分压（PaOn 2）、动脉血二氧化碳分压（PaCOn 2）、动脉血氧饱和度（SaOn 2）]、肺动脉压力（SPAP）、体循环血压（SBP），比较四组患儿机械通气治疗时间、住院时间、住院费用及不良反应发生情况。n 结果:A、B、C组治疗有效率均高于D组[80.0%（32/40）、85.0%（34/40）、87.5%（35/40）比57.5%（23/40）]，差异有统计学意义（n P0.05）；治疗后A、B、C组PaOn 2高于D组，B、C组PaCOn 2低于D组，B、C组SaOn 2高于D组，差异均有统计学意义（n P<0.05）。治疗后B、C组SPAP显著低于D组[（28.56 ± 3.93）、（27.14 ± 3.32） mmHg（1 mmHg = 0.133kPa）比（33.57 ± 4.68） mmHg]，差异有统计学意义（n P0.05）。A、B、C组机械通气治疗时间、住院时间短于D组，住院费用少于D组，差异均有统计学意义。治疗过程中所有患儿均未发生药物相关不良反应及并发症。n 结论:机械通气联合西地那非治疗可明显降低PPHN患儿肺动脉压力，改善肺氧合状态；在0.5~1.0 mg/kg剂量，增大西地那非剂量，疗效更显著。“,”Objective:To observe the efficacy and safety of mechanical ventilation combined with different doses of sildenafil in the treatment of persistent pulmonary hypertension of newborn (PPHN).Methods:A total of 160 children with PPHN admitted to Dezhou Maternal and Child Health Hospital from January 2018 to December 2019 were selected and divided into group A, B, C and D by random stratification, with 40 cases in each group. All the children in the group were actively corrected for acidosis, provided with intravenous nutrition support, warmth, anti-infection and other measures, and adopted ventilator to assist mechanical ventilation. Group A, B, and C were given different doses of sildenafil 0.5, 1.0, and 2.0 mg/(kg·time) respectively, while group D was not given sildenafil treatment, but only mechanical ventilation. Blood gas analysis indexes including partial arterial oxygenpressure (PaOn 2), partial arterial carbon dioxide pressure (PaCOn 2), saturationoxygen (SaOn 2), and pulmonary artery pressure (SPAP), systemic blood pressure (SBP) of children were tested before the treatment and 72 h after the treatment. The treatment time, hospitalization time, hospitalization expenses and the incidence of adverse reactions of mechanical ventilation in 4 groups were recorded and compared.n Results:The effective rate in the group A, B and C was higher than that in the group D: 80.0%(32/40), 85.0%(34/40), 87.5%(35/40) vs. 57.5%(23/40), the difference was statistically significant (n P0.05). After treatment, the level of PaOn 2 in the group A, B and C was significantly higher than that in the group D (n P<0.05), the level of PaCOn 2 in the group B and C was significantly lower than that in group D (n P<0.05), and the level of SaOn 2 in the group B and C was significantly higher than that in the group D (n P<0.05). After treatment, the level of SPAP in group B and C was significantly lower than that in the group D: (28.56 ± 3.93), (27.14 ± 3.32) mmHg(1 mmHg = 0.133 kPa) vs. (33.57 ± 4.68) mmHg,n P0.05). The hospitalization time and mechanical ventilation time in group A, B and C were significantly shorter than those in group D (n P<0.05). No drug-related adverse reactions, pulmonary hemorrhage, hypotension, arrhythmia, pneumothorax and other complications occurred during the treatment in the 4 groups.n Conclusions:Mechanical ventilation combined with sildenafil can significantly reduce pulmonary artery pressure and improve pulmonary oxygenation in children with PPHN. In the range of 0.5 - 1.0 mg/kg, the efficacy is more obvious when increasing the dose of sildenafil.